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Doctor dispensing is no longer relevant and undermines pharmacy

I have been a community pharmacist since 1974 and am now semi-retired. I have been fortunate enough to have lived and worked all my life in an area of outstanding natural beauty in North Wales; within ten minutes of locking the pharmacy I could be on the golf course or out in the bay on the boat — perfect!

So now that I am in the twilight of my career and have ceased involvement with the company I helped to start, I feel that I must vent my feelings on one of the great injustices in life: namely doctor dispensing.

Surely, in the 21st century — when students who have chosen pharmacy endure four demanding years in college followed by a further year in practice before sitting a final examination — it is fundamentally wrong that unqualified people are allowed to dispense medicines to members of the public. I find it even more alarming that one person can diagnose, prescribe and dispense medicines, and are ideally placed to cover up any errors made; did we learn nothing from the Harold Shipman episode?

Doctor dispensing was introduced to make it easier for patients in remote rural areas to have access to medicines, and, as far as I am aware, the criterion to this day is that they must reside more than a mile from the nearest pharmacy. But times have changed significantly. Our pharmacies have a delivery service, as do all other local pharmacies, so this situation no longer exists. In one village eight miles from here, the doctor’s dispensing surgery is less than one hundred yards from a long-established pharmacy — madness! There is no doubt, however, that GPs see this as a very lucrative source of income, especially without having the need to employ a pharmacist.

The local surgeries are all struggling under their increased workloads, and many are relinquishing NHS contracts. Patients are often informed through social media that there is only one doctor in the practice on a certain day and that no appointments are available. I agree that they work extremely hard during their allotted hours (as do pharmacists), and that patients are now far more demanding, but with no weekend work or callouts, and excellent remuneration, it seems a far cry from the times when local GPs followed the ambulance carrying their ailing patient half way to Bangor hospital! Pharmacists are finally beginning to be recognised as highly trained advisers on illness and knowledgeable about alternatives to a surgery visit.

I believe that it is time for our profession to highlight the dangers of this practice to the public, many of whom believe that they must collect their medication from the surgery and are unaware that they have a choice. The era during which doctors evoked a ‘God-like’ aura is long gone and patients are aware of their human failings.

Dispensing errors occur in all pharmacies — we had a system whereby prescriptions were checked three times before bagging for collection, and even then, although thankfully rarely, a mistake would creep through. How many mistakes occur under non-qualified supervision? Furthermore, in our litigation-driven society, could a health board condoning unqualified dispensing be held responsible and sued?

This situation should not be allowed to continue, and is an insult to the whole concept of pharmacy.

 

Emyr Wynne Evans,

Member, Royal Pharmaceutical Society

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2018.20204370

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